Lung disease patients urged to exercise

TAKE A BREATHER:：A physiotherapist has outlined doctor-recommended exercises to help patients with chronic pulmonary disease cope with the changing weather

By Jake Chung / Staff writer, with CNA

Thu, Sep 19, 2013 - Page 4

Physiotherapists are recommending a series of exercises for chronic obstructive pulmonary disease (COPD) patients to help improve their lung capacity to better cope with the shifting weather, Changhua Christian Hospital physiotherapist Lee Chun-shien (李俊賢) said yesterday.

The damaged pulmonary alveoli — small air sacs in the lungs — and swollen, mucus-clogged bronchioles — tiny airway tubes — of patients with COPD impair their capability to exhale carbon dioxide, which then becomes trapped in their lungs, Lee said.

Over time, COPD sufferers’ inability to get enough oxygen damages their cardiopulmonary system and can lead to respiratory failure, Lee added.

Treatment often includes anti-inflammatory drugs, medicine to open up the bronchial tubes and therapy, the physiotherapist said, adding that the No. 1 cause of COPD in Taiwan is smoking.

The first set of exercises physiotherapists recommend to help patients cope with the climatological changes by which they are affected more than non-sufferers is abdominal breathing, Lee said.

To do the exercise, the person should allow their abdomen to swell as they inhale through the nose and then forcefully contract their abdominal muscles as they exhale, while keeping one hand on their abdomen and the other on their chest.

This action serves to alleviate breathing difficulties by keeping the airways open and boosting oxygenation and should be done at least 10 times for maximum effect, Lee said.

Such exercises can be done during work breaks, but should be avoided within an hour of eating or if one is feeling dizzy, as it would increase the feeling of dizziness, the physiotherapist added.

In the second exercise, the person sits leaning slightly forward and exhales while crossing their arms in front of their chest, before spreading them to either side as they inhale, Lee said, adding that this exercise should be repeated 10 times, thrice a day.

The third exercise is to stand or sit at ease while leaning forward about 20o to 45o, while the fourth involves triggering a cough, Lee said.

To incite a coughing attack, the patient should take a deep breath, hold their breath for several seconds — causing phlegm to rise — then exhale as quickly as possible, setting off the body’s coughing mechanism to expel the mucus, Lee said, adding that it is important to let the cough come naturally and not force it.

The final exercise is aerobic and focuses on rhythmic, repetitive movements involving the cardinal muscle groups, such as hiking, stair-climbing, jogging or biking, Lee said, adding that the only rule was that each session should last at least 15 to 20 minutes.

He reminded patients that if, while performing aerobic exercises, they feel uncomfortable, or experience an overtly high blood pressure rate or heart beat that leads to shortness of breath, they should stop immediately.

More than 80 percent of COPD patients experience increased amounts of phlegm, more frequent coughing and get more easily out of breath when walking or moving heavy things when the weather changes, especially as summer fades into autumn.

These symptoms are not limited to people who are smokers and research has shown that even after many years, ex-smokers may still develop COPD, Lee said, adding that it was more difficult to diagnose former smokers in the initial stages of the disease.

For those who have quit cigarettes, or who do not smoke, but inhale second-hand smoke constantly, the exercises have proved effective in preventing and alleviating COPD symptoms, Lee said.